A74 Safety and early outcomes of the artisse intrasaccular device in acutely ruptured intracranial aneurysms: initial results from the INSPIRE-a registry

Résumé fourni par la source

Background/Introduction Treatment of acutely ruptured wide-neck bifurcation aneurysms remains challenging. Intrasaccular flow disruption may offer early aneurysm protection without mandatory need for dual antiplatelet therapy (DAPT). We evaluated procedural and early safety outcomes of the Artisse device in acutely ruptured intracranial aneurysms (RIAs). Objective/Purpose Evaluate the safety and clinical/angiographic outcomes at 6 months of the Artisse device (Medtronic) in RIAs. Methods/Case Description We analyzed RIAs treated with Artisse in the prospective, real-world, multicenter INSPIRE-A registry. Key outcomes included procedure/device-related serious adverse events (SAE), stroke, and rebleeding through 6 months. Results/Findings 27 patients (mean age 55.6 years, 66.7% women) were included with additional enrollment ongoing. RIAs were primarily located in the AComA (65.4%) and MCA (34.6%), with mean neck width of 4.22 mm. Implant success was 100%. Most procedures (84.6%) required no adjunctive devices. Notably, 55.6% of patients received no antiplatelet therapy in the acute setting. No target aneurysm rebleeding or deaths occurred through 6 months. There were 4 strokes in 3 patients of which only 1 was in treated vascular territory, adjudicated by the CEC as causally related to procedure and possibly related to device and absence of antiplatelet therapy. SAEs occurred in 7.4% during the acute phase. At 6 months, 93.8% of patients achieved a favorable functional outcome (mRS ≤2). Discussion/Conclusions/Learning Points In this multicenter cohort with early follow up, Artisse demonstrated favorable safety profile in RIAs. The absence of rebleeding and the feasibility of a no-antiplatelet strategy in over half of the cases support Artisse as a treatment option for RIAs. Additional follow up data on more patients is needed to assess effectiveness of Artisse in this population.